pediatric burn care

true

scald burn wounds are the most common among children and flame among adults

t or f

false

contact burn wounds are the most common among children and scald in adults

t or f

under 3 years

___ of age see scalding liquids, coffee, tea and contact burns from glass are the most common MOI for burns at home

5-10 years

___ of age see fire play, risk taking, matches, scalding liquids are the most common MOI for burns at home

adolescents

__ of age see dare type behaviours, copying stunts, gasoline are the most common MOI for burns at home

true

wounds which take 2-3 weeks or longer to heal are at higher risk of scarring including deep burn injuries and skin grafts

t or f

false

wounds which take 4-5 weeks or longer to heal are at higher risk of scarring including deep burn injuries and skin grafts

t or f

true

a scar is considered active from the time of injury to 6-9 months post injury while taking 1 year for the scat to fully mature

t or f

false

a scar is considered active from the time of injury to 7-9 months post injury while taking 1.5 yearda for the scat to fully mature

t or f

day 0

at ___ the emergency room is used to address wound, debride and apply dressing

day 2-3

at ___ the burn unit is used to change dressings under sedation, and apply silver dressings

day 10

at ___ the burn unit is used and involves changing dressings under sedation

outpt follow up

by day 14 if the wound is healing well the pt is sent to ____

operative treatment

by day 14 if the wound is healing poorly and requires grafting pt is sent to

emergent/resuscitative phase

the phase of burn management involving addressing immediate problems caused by burn injury such as hypovolemic shock and edema formation

acute phase

the phase of burn management involving wound care (spontaneous healing, skin allografting and autografting) with positioning, ROM, dec deconditioning and inc functional independence

allograft

use of cadaver skin to promote healing and prepping the wound bed for skin grafts

true

those who received an allograft have no activity restrictions and requires dressing changes for 7 days

t or f

false

those who received an autograft have no activity restrictions and requires dressing changes for 7 days

t or f

autograft

the use of split thickness skin graft or a full thickness skin graft made of the pt own skin

split thickness skin graft

skin graft composed of the epidermis and a superficial part of the dermis

full thickness skin graft

skin graft containing the epidermis and the entire dermis

true

those with an autograft have activity restrictions and is on bed rest until cleared by surgeon

t or f

false

those with an allograft have activity restrictions and is on bed rest until cleared by surgeon

t or f

true

the position of comfort is often the position of contracture

t or f

false

the position of comfort is often the position of prevention of contractures

t or f

true

preventative positioning is used to maintain skin integrity, elongation of the wound, contracture prevention and dec edema formation

t or f

false

comfort positioning is used to maintain skin integrity, elongation of the wound, contracture prevention and dec edema formation

t or f

maintaining skin integrity

with positioning to help ____ it can include use of an air mattress, t-foam to support bony prominences and repositioning often

elongating the wound

with positioning to help ____ avoid position of comfort

prevent contractures

with positioning to help ____ keep joints in neutral and making a positioning poster

reduce edema formation

with positioning to help ____ by elevating limbs and using compression techniques

true

in a pt with a autograft to the R ant shoulder and axilla would benefit from alternating bw SL and supine with the arm abducted to 90 deg

t or f

false

in a pt with a autograft to the R ant shoulder and axilla would benefit from alternating bw SL and prone with the arm abducted to 90 deg

t or f

edema management

apart of acute burn management causing swelling from inflammation, and fluid resuscitation impacting joint ROM using positioning, AROM and pressure

range of motion

due to intubation and sedation causing immobility and contracture risk requires daily ____ sessions with nursing cares

pain management

burns leads to open wounds, injured nerve endings, inflammation and contractures requiring ____ such as balancing medication with treatment, monitoring vitals, and pain scales

closed dressings

dressings which fully seal the wound and reduces the # of painful procedures, dec length of the stay and inc pt comfort under sedation

immobility

lead to dec flexibility, dec endurance and muscle atrophy from burn wound

scar massage

used to help w scar management in the rehab phase preparing the skin prior to the stretches and softens/desensitizes the scar with blanching pressure

stretching

used to help w scar management in the rehab phase to prevent permanent scar contracture to the point of blanching, and in areas of inc scarring postential

silicone

used to help w scar management in the rehab phase based on OT recs to help soften the scar in splints or under garments

compression garments

used to help w scar management in the rehab phase based on OT measurements worn throughout most of the day on closed wounds to dec hypertrophic scar formation making it flatter and softer

splinting

used to help w scar management in the rehab phase based on OT fabrication to maintain PROM

ongoing care

apart of burn management near the end of scar maturation to monitor ongoing needs such as contracture development and further intervention needs until the child stops growing

contractures

___ in ongoing burn care can occur from the location, prolonged immobilization, poor positioning in early phases, scar management, and physical growth

true

typical burn contracture management follow up 1-2 years until they turn 18 to monitor burn scars and growth

t or f

false

typical burn contracture management follow up 2-3 years until they turn 18 to monitor burn scars and growth

t or f

serial casting

used in ongoing care to maintain/improve ROM is the pt is unable to maintain w splints and home programs and done under anesthesia

true

during serial casting the PT stretches then casts the pt to closest end ROM possible with recasting and assessing every 7-10 days

t or f

false

during serial casting the PT first casts the pt to closest end ROM possible with recasting and assessing every 7-10 days

t or f

surgical release

used in ongoing care in pts with functional impairment, loss of joint mobility and hygiene points despite extensive rehab program

laser treatments

used in ongoing care 3 months post injury/graft or mature scars under sedation to help manage pain, scar quality and more

pulsed dye laser

laser treatment used to dec pruritus, erythema, pain and improving the burn wound appearance

CO2 laser

laser treatment used to improve overall scar quality, dec scar height and texture, and inc pliability, dec surgery need or extent of the surgical procedures t

true

for laser treatments PT helps indentify pts w indicators for laser treatments and guides HEP

t or f

false

for laser treatments PT helps indentify pts w indicators for laser treatments and applies laser treatment

t or f